Abstract:Linear IgA dermatosis is a rare subepidermal autoimmune blistering disease
characterized by linear deposition of IgA along the basement membrane zone. In
the last three decades, many different drugs have been associated with the
drug-induced form of the disease, especially vancomycin. We report a case of
vancomycin-induced linear IgA disease mimicking toxic epidermal necrolysis. The
aim of this work is to emphasize the need to include this differential diagnosis
in cases of epidermal detachment and to review t… Show more
“…The major differential diagnosis in this case was TEN. LABD presenting as TEN has already been published . All reported cases except one could be linked to drug intake.…”
Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive form of peripheral T-cell lymphoma, characterized by systemic symptoms, diffuse lymphadenopathy, hepatosplenomegaly and immunodysregulation. Half of AITL is associated with cutaneous symptoms, but only few cases with bullous eruption have been described.Association with a linear IgA dermatosis is extremely rare. Linear IgA dermatosis can
“…The major differential diagnosis in this case was TEN. LABD presenting as TEN has already been published . All reported cases except one could be linked to drug intake.…”
Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive form of peripheral T-cell lymphoma, characterized by systemic symptoms, diffuse lymphadenopathy, hepatosplenomegaly and immunodysregulation. Half of AITL is associated with cutaneous symptoms, but only few cases with bullous eruption have been described.Association with a linear IgA dermatosis is extremely rare. Linear IgA dermatosis can
“…In adults, it is commonly induced by drugs and the main drug related to LABD is vancomycin . Vancomycin‐induced LABD is associated with a severe presentation of the disease that may mimic toxic epidermal necrolysis (TEN) . There have also been numerous reports of LABD mimicking erythema multiforme and TEN but not many reports of this disease with mucosal presentation similar to a herpetic infection and evolving to a bullous pemphigoid‐like clinic presentation.…”
Key clinical message
We report an uncommon presentation of bullous dermatosis by linear IgA. There are few cases reported in the literature with this form of presentation starting with mucosal lesions and then evolving into a similar bullous pemphigoid pattern. In addition, we emphasize the importance of direct immunofluorescence for the definitive diagnosis.
“…The disease occurred probably because of 2 factors: drug and infection together. The majority of patients with reported druginduced LABD also had other diseases, such as neoplasia (1,7,(30)(31)(32)(33)(34), diabetes (1,30,(35)(36)(37)(38), heart and lung diseases (1,36,(39)(40)(41)(42), rheumatoid arthritis (43)(44)(45) or ulcerative colitis (18,19). Concomitant diseases may also be implicated in triggering the onset of suspected druginduced LABD (30).…”
Section: Pathogenesis Of Drug-induced Linear Iga Bullous Dermatosismentioning
Linear IgA bullous dermatosis (LABD) is a rare blistering autoimmune disease. Although most cases are idiopathic, numerous drugs have been identified as capable of eliciting LABD. This paper provides an overview of the pathogenesis, diagnosis and treatment of drug-induced LABD, together with a report of a representative case of vancomycin-induced LABD. In addition, the results of a comprehensive literature review are reported to provide an overview of putative culprit drugs and their frequency, in order to enable clinicians to diagnose patients with putative adverse drug reactions presenting with blistering. Linear IgA bullous dermatosis (LABD) is a rare subepidermal autoimmune blistering disease characterized by linear deposition of IgA along the basement membrane zone. Although most reported cases are idiopathic, there is a subset of patients with drug-induced LABD. Various drugs have been associated with the drug-induced form of the disease. This paper reviews the literature on drugs reported to elicit linear IgA dermatosis and its specific clinical presentation. In addition, a case report of a 77-year-old male patient with linear IgA dermatosis induced by vancomycin is described. The aim of this paper is to emphasize the need to include this differential diagnosis in cases of suspected adverse drug reactions, as well as to highlight the role of drugs in LABD.
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